Exchange, carriers struggle to serve newly insured

California’s new health insurance exchange has gotten kudos in recent months for enrolling the most people in the nation, and generally has had fewer paralyzing glitches than the federal government’s, but that doesn’t mean Obamacare has arrived in the state without its share of problems.

And Covered California came under fire this week from insurance agents and advocacy groups, who complained about continued long wait times on the exchange’s three telephone call centers, numerous problems with the online enrollment site and multiweek lag times in getting policy paperwork transferred from the exchange to insurance companies.

“This has been a wild last three months,” he said. “Many have had a less-than-ideal experience.”

He said Covered California was in the process of hiring 350 additional call center employees, mostly in Fresno, and dedicating a phone line for insurance agents and certified enrollment counselors.

Additionally, the exchange will add bilingual staff, fix numerous problems with its Spanish-language website and expand the capacity of its service centers so callers don’t receive a busy signal or get bumped off. It already has been addressing a glitch on its main website that in essence deterred families from signing up for pediatric dental care.

Many of the complaints, whether they have to do with the exchange or with individual insurance carriers, involve very slow service, especially when trying to speak to a real human being.

Jeffrey Handler of Kensington said he has struggled simply to pay his bill to Blue Shield of California. Handler said he has received notices that he should pay his bill for February or lose coverage, but he can’t get through to anyone to make payment.

“There is no way to pay them. You go on the website to try and pay and it logs you out. There is no way to do it online, and their phone lines for their call center are just fried,” Handler said.

But others, like John Neustadt, a naturopathic doctor from Encinitas, have had more convoluted problems.

Neustadt said it took two weeks, and hours on the phone, to resolve a situation where he was triple billed after choosing an Anthem Blue Cross plan from Covered California.

Neustadt said he and his family recently moved to California from Montana and found that they could not get a new family plan because he had a pre-existing condition. This had forced the family to have two policies, one for Neustadt’s wife and two children and a second one for him.

But that configuration created problems when it came time to buy new policies. Because health reform bans insurance companies from denying coverage based on pre-existing conditions, the family was able to sign up for a single family plan through Covered California.

But, in early January, three bills arrived.

One policy listed his wife and two children at a cost of $418 per month while another listed the same three people at a price of $997 per month and included his wife in a pediatric dental plan. Neustadt’s name was nowhere to be found on either policy but did appear on a third bill for $755. That bill was for his old single policy that was supposed to be canceled when the new Covered California family plan started.

Getting the mess sorted out, he said, took two weeks and three or four hours of phone calls with Anthem representatives.

Darrel Ng, a spokesman for Blue Cross, said Friday that Neustadt’s situation was “unique” because he had been on a different Blue Cross plan than his wife and child in 2013.

“There wasn’t a clean, automated, way to combine two existing policies into one policy and manual intervention had to occur,” Ng said, adding that he had no numbers on how many Californians were in a similar position.

Ng said that, while Neustadt’s situation is rare, many people have been double billed if they waited until after Dec. 15 to select a new plan.

“In a double-billing situation, anyone who calls us, we cancel the second plan,” Ng said.

Marta Green, a spokeswoman for the California Department of Managed Health Care, said her department has received 200 complaints about Covered California plans since Dec. 31. While that number might seem low, given that 625,000 Californians have signed up, Green said that most enrollees learn about her department from plan material distributed by the insurance companies.

Given that many Californians have not yet gotten that material, she said the complaint number may not be an accurate reflection of how many Californians are having problems. She said the department investigates every complaint it receives and has the authority to issue fines if insurance companies have violated laws that govern insurance statewide.

“It’s too early for us to say we’ve uncovered violations of the law. We’re still processing those complaints and trying to get issues resolved,” Green said.